Ms 






UNITED STATES PUBLIC HEALTH SERVICE 

RUPERT BLUE, Surgeon General 



MENTAL STATUS 
OF RURAL SCHOOL CHILDREN 

REPORT OF PRELIMINARY SANITARY SURVEY 
MADE IN NEW CASTLE COUNTY, DELAWARE, . 
WITH A DESCRIPTION OF THE 
TESTS EMPLOYED 

BY 

E. H. MULLAN 

Passed Assistant Surgeon 
United States Public Health Service 



REPRINT No. 377 

FROM THE 

PUBLIC HEALTH REPORTS 

November 17, 1916 
(Pages 3174-3187) 

WITH 

THE MENTAL STATUS OF RURAL SCHOOL CHILDREN 

OF PORTER COUNTY, INDIANA 

BY 

TALIAFERRO ^LARK, Surgeon 

AND W. L. TREAD WAY, Assistant Surgeon 

United States Public Health Service 

Reprinted from Public Health Bulletin No. 77 




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1916 



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D. Of D. 
MAR 28 1917 






MENTAL STATUS OF RURAL SCHOOL CHILDREN. 

EEPORT OF PRELIMINARY SANITARY SURVEY MADE IN NEW CASTLE COUNTY, DEL- 
AWARE. WITH A DESCRIPTION OP THE TESTS EMPLOYED.i 

By E. H. MuLLAN, Passed Assistant Surgeon, United States Public Health Service. 

At the request of the Delaware State board of health, State board 
. of education, and Cooperative Educational Association, the United 
States Public Health Service undertook a sanitary survey of the 
rural schools of New Castle County, including the mental status of 
the school children. This survey is part of a series of cooperative 
investigations of educational, health, and sociological conditions in 
the State of Delaware by the Public Health Service, the National 
Bureau of Education, the Children's Bureau, and other agencies. 
In order to supply certain data desired by the Children's Bureau in 
their investigations, the mental survey herein reported was con- 
ducted prehminary to the general survey. It continued from Janu- 
ary 6 to May 1, 1916. 

During this investigation 3,793 children were studied. Of these, 
19, or 0.5 per cent of the total, were found to be definitely feeble- 
minded and in need of careful supervision or institutional treatment. 
In addition, 50 other children, or 1.3 per cent of the total number 
examined, exhibited abnormal mental symptoms to such an extent 
as to be considered probable mental defectives. 

At the beginning of this survey a majority of the school children 
were tested by the Binet-Simon scale, and those who showed symp- 
toms of mental abnormality were examined by supplemental methods. 
The routine giving of the Binet tests to every pupil was soon re- 
placed by a briefer sifting process for the purpose of finding those 
children of low intelligence or those in whom mental peculiarities 
existed. This brief examination was composed of questions and tests 
suited in a general way to the child's age and school grade. 

If, during this prehminary examination or sifting process, symptoms 
arose which suggested mental abnormality, the case was examined 
more thoroughly. At this secondary examination every effort was 
made to arrive at a correct diagnosis in so far as one sitting would 
permit, and each suspected pupil was given Goddard's modification 
of the Binet tests, together with other tests and questions. This re- 
examination lasted from 20 to 50 minutes. 

In the city ^ and town schools which were graded or partially 
graded, the children were questioned one at a time in the principal's 
office or other room. In practically all of the rural schools, however, 

1 Reprint from the Public Health Reports, vol. 31, No. 46, Nov. 17, 1916, pp. 3174-3187. 

2 In the city of New Castle approximately 225 children were given the Biaet-Simon examination. 

70793°— 16 3 



4 MENTAL STATUS OF RURAL SCHOOL CHILDREN. 

the examination was conducted in the schoolroom in the presence of 
the teacher and pupils. When the weather became warm all the 
children were sent to the playground- with the exception of those 
belonging to one grade, each grade being called in separately for 
examination. During the testing the teacher was instructed to give 
those present various tasks which could be quietly performed at their 
desks. Recitations were forbidden during the examinations, as noise 
of any kind interfered with the testing, and especially with that 
form of testing known as the repetition of digits. 

BINET-SIMON EXAMINATIONS. 

Manner of giving tests. — In making a Binet examination each child 
was permitted to try every test whenever there was a possibility of 
his performing it. 

Every pupil over 7 years of age was tested with the IX-year series 
of tests, because normal and abnormal pupils are met with who can 
qualify in all of the X-year tests and yet fail on one or more tests of 
the IX-year group. No Binet tests higher than the Xll-year series 
were used, since tests devised for higher age groups have not proved 
reliable.^ 

Result. — The results of the Binet-Simon examination of 209 normal 
cliildren, 174 white and 35 colored, in the city of New Castle, are 
presented in the subjoined table: 

Table I. — Binet ages of 209 normal children {174 white, 34 colored) in the city of 

New Castle. 



Chrono- 
logical 
age. 


Mental age. 




cq 


00 


cq 


■* 


C<1 


"2 

"2 
1 
1 
4 
2 


00 



1 

i 

2 

"i 
1 

1 
2 

3 
1 
1 

2 





3 
3 

'2 
1 

'2 

'i 

14 




tH 



2 

i 
2 
1 
1 

3 
13 


eq 



11 




'i 
5 
1 

5 

2 
1 

1 

16 


00 
10 




i 

'i 

1 

'2 

1 

6 


■* 

"i 

1 

i 
1 
1 

1 

'2 

1 

9 


IN 

C33 

'i 

.. 

'3 

"3 

5 
1 

2 

1 

16 


i 
1 

3 

1 

3 
3 
1 

13 


00 
00 

11 


to 
00 

'i 

1 

"i 

2 

i 

6 


00 

■" 

6 


!N 

00 

"2 
1 
1 

6 


00 


i 

"2 


00 


to 


'i 


-• 
'2 


"3 


00 

CO 



"i 
"i 




CO 

■■ 
i 


to 

i 


-• 

i 


to 


00 


to 


10 


CO 

10 


in 




15 - 










'i 

1 
2 


i 

1 

i 


3 


14.5 

14... 


1 






'l 
1 

1 


2 
5 


13.5 






2 


s 


13 






7 


12.5 








11 


12... 








2 
'2 


11 


11.5 




1 


1 
1 


n 


11 




IS 


10.5 






n 


10 








ifi 


9.5 














13 


9 














15 


8.5 














17 


8 

7.5 

7 

6.5 

6 


1 


1 


4 


7 


8 


12 


16 


21 
11 
11 


14 


Total.. 


3 


4 


3 


1 


2 


4 


2 


1 


1 


1 

















1 


209 



' In the IX-year group of tests the subtraction of 4 from 20 abstractly was used instead of the actual count- 
ing out of change. 

In the Xl-ycar series, the giving of 20 words in 30 seconds was considered the equivalent of giving 60 
words in 3 minutes. This consideration was based on some previous experimental work. 

The dissected sentences of the Xl-ycar series, according to Goddard's correction of April, 1913, were 
used. 

In the "Resisting suggestion" test of the Xll-year group, two correct judgments out of the last three 
judgments were scored as a satisfactory reply. 



MENTAL STATUS OP RURAL SCHOOL CHILDREN. 5 

Although 209 Bhiet exammations are a small number, this table 
shows the wide variation which exists i!i the Binet ages of children 
who are not considered defective. 

SIFTING PROCESS. 

On January 27 the sifting process replaced the routine Binet 
examination, beginning with the seventh grade of the New Castle 
School. The sifting method, and reexamining when necessary by 
the Binet and other methods, was continued throughout the survey. 

The weeding out process was instituted simply to bring out the 
child's mentation in order that subnormal or abnormal suspects 
could be separated from the average children. It is beUeved that 
almost any simple test or series of simple tests could be used for this 
purpose. After due consideration, the cube test, the repetition of 
digits, and problem were selected. These three tests, occupying 




about four or five minutes, were thenceforth used in the examina- 
tion of every child. 

Cube Test. 

The cube test, which has proved its usefulness in the mental 
examination of arriving immigrants, was the first test given to each 
child. This test consists in the touching of four or five cubes by the 
examiner in a definite order, immediately after which the subject 
strives to imitate the examiner, touciiing the same cubes in the same 
order. 

In the diagram four cubes are represented. They are on a table 
immediately in front of the subject. The movement here depicted 
shows that the examiner is touching cube 1 with his finger, after 
which he immediately touches cube 4, then after a slight pause 
(one-half to two seconds) he touches cube 2, and immediately after- 
wards cube 3. The subject then imitates the examiner. The ex- 
aminer next touches the four blocks in a different order, which 
operation in turn is executed by the subject. 

Tlie following six movements were selected for the four-cube test, 
the numbers indicating the different cubes: 



First 


1 


4 


2 


8 


Fourth 


4 


2 


3 


1 


Second ...... 


1 


3 


4 


2 


Fifth 


3 


2 


4 


1 


Tliird 


1 


3 


2 


4 


Sixth 


2 


4 


1 


3 



6 ' MENTAL STATUS OF RURAL SCHOOL CHILDREN. 

The execution of these six movements on the part of the examiner 
and the repetition of them by the subject ordinarily requires from 40 
to 60 seconds. Two trials were allowed only for the first movement. 

The follomng four movements were used in the five-cube test. 
The longer spaces between the digits indicate a time interval of from 
one and one-half to two seconds; in other words, a distinct pause 
occurred midway in the movement. 

First 1 4 5 2 3 I Third 5 13 4 2 

Second...... 2 4 1 3 5 1 Fourth 4 3 5 2 1 

In giving the cube test, a sufficient time mentally to recover was 
allowed after each movement. The weighted cubes used in the 
weight-discrimination test were used for this test. 

During the cube test the subject was carefully observed. His 
general get-up, facial expression, -amount of self-reliance, power of 
comprehension, muscular control, rapidity of movement, attention 
over a period of 45 seconds, emotional state, and accuracy of per- 
formance were all noticed. 

The fom"th movement of the four-cube test brought out the sub- 
ject's power to resist suggestion, and the different movements of the 
five-cube test permitted analytic processes to take place. Good vision 
is essential for the performance of this test. 

The five-cube test was used in the sixth, seventh, and eighth 
grades. Children of the lower grades were examined with the four- 
cube test. 

Most of the children in the upper grades succeeded in performing 
two movements out of the four movements with the five-cube test, 
this being considered satisfactory. Whenever a subject succeeded 
in all four movements with the five-cube test his general examination 
record was usually excellent. 

Ability to succeed in at least four movements out of the six move- 
ments with the four-cube test was considered a satisfactory per- 
formance. Satisfactory performances with this test are not accom- 
pHshed until the child reaches the age of eight. This is proven by 
the tables inserted below. These show how 1,393 white children 
between the ages of 6 and 10 in the rural schools of New Castle County 
performed the four-cube test. 

Table W.—^Fow-cvhe test. 

Record of 1,393 white children in New Castle County, Del. 

178 children, age 6. 

14 children accomplished 6 movements] 

20 children accompIisJied 5 movements >64 children, or 36 per cent, succeeded in 4 movements. 

30 children accomplished 4 movements) 

28 children accomplished 3 movements] 

35 children accomplished 2 movements!,. . „>,iiriraTi 

19 children accomplished 1 movement. | cniiaren. 

32 children accomplished movement.] 



MENTAL STATUS OF RURAL SCHOOL CHILDREN. 7 

Table II. — Four-cube test — Continued. 

135 children, age 7. 

14 children accomplished 6 movements] 

36 children accomplished 5 movements >85 children, or 63 per cent, succeeded in 4 movements. 

35 children accomplished 4 movements! 

16 children accomplished 3 movementsj 

14 children accomplished 2 movements Lf^ , .,, 
12 children accomplished 1 movement, r" tuiiuieu. 

8 children accomplished movement. J 

H.7 children, age 7j. 

23 children accomplished 6 movements] 

48 children accomplished 5 movements >104 children, or 71 per cent, succeeded in 4 movements. 
33 children accomplished 4 movements) 

17 children accomplished 3 movements] 

19 children accomplished 2 movementsLo phiirirAn 

5 children accomplished 1 movement, r^ i-nnu^en. 
2 children accomplished movement.) 

17 i. children, age 8. 

40 children accomplished 6 movements] 

49 children accomplished 5 movements Vl33 children, or 76 per cent, succeeded in 4 movements. 
44 children accomplished 4 movements) 

24 cliildren accomplished 3 movements] 

7 children accomplished 2 movementsL, „hiirirAn 

6 children accomplished 1 movement, r^ ""i^eu. 
5 children accomplished movement. )- 

192 children, age 8|. 

55 children accomplished 6 movements] 

52 children accomplished 5 movements J-150 children, or 78 per cent, succeeded in 4 movements. 
43 children accomplished 4 movements) 
31 children accomplished 3 movementsj 

9 children accomplished 2 movements! .„ ,i,^ 

1 child accomplished 1 movement. . . . P^ cnnaren. 
1 child accomplished movement — j 

170 children, age 9. 

61 children accomplished 6 movements] 

47 children accomplished 5 movementsMSl children, or 77 per cent, succeeded in 4 movements. 

23 children accomplished 4 movements) 

23 children accomplished 3 movements] 

12 children accomplished 2 movements W9 children. 

4 children accomplished movement, j 

230 children, age 9^. 

92 children accomplished 6 movements] 

77 children accomplished 5 movements >211 children, or 92 per cent, succeeded in 4 movements. 

42 children accomplished 4 movements) 

13 children accomplished 3 movements] 

5 children accomplished 2 movementsJ-19 children. 
1 child accomplished movement ) 

167 children, age 10. 

51 children accomplished 6 movements] 

56 children accomplished 5 movements >138 children, or 83 per cent, succeeded in 4 movements. 
31 children accomplished 4 movements) 

20 children accomplished 3 movements] 

4 children accomplished 2 movements j^^ ^hiiriT-on 
1 child accomplished 1 movement .... p •^^"'^'^®'^ • 
4 children accomplished movement.) 

Repetition of Digits. 

The repetition of digits followed the cube test. In giving this test 
the examiner gave the digits rather rapidly, allowing a small interval 
of time to occur midway in the enunciation of the digits. This small 
interval of time, less than a second, may be represented by a space in 
the following series: 179 286; 1395 847; 4792 3815. The tone of the 
examiner's voice in propounding this test may be characterized by the 
term "musical." The usual enunciation in monotone of each digit, 
recommended m textbooks on psychology, was not used. 



8 MENTAL STATUS OF EUEAL SCHOOL CHILDREN. 

With one exception, two trials were given for the repetition of each 
series of digits; that is, the subject was' given two trials to repeat 
six digits, two trials to repeat eight digits, and so on, a different 
series of numbers being used. The exception above referred to is 
as follows: When a subject had reached the age of 12 he was given 
seven or eight trials, if necessary, to repeat seven digits. The time 
spacings between the different digits were varied at each trial. 
These variations may be thus represented: 179 2864; 1495 387; 59 
17 28 4. 

If a child of 12 or over was unable to repeat seven digits after 
several trials, the examiner would say to him: 

Just listen. Do not say these numbers to yourself. Say them quickly to me as 
Boon as I finish. 

This is a test in sound. If you stop to think of these numbers you will lose them. 
Just say them quickly to me. 

Every effort was made to get the child pf 12 years and above to 
repeat seven digits. It was found that among the children examined 
the failure of those of 12 and over to repeat seven digits was a symp- 
tom in many instances of mental deficiency. As a rule, it was found 
that children thus failmg made a poor showing in many of the other 
mental tests. A number of mentally defective persons who were able 
to repeat six digits at first soon tired in their effort to repeat seven, 
became inattentive, and later were unable even to repeat six. 

The following tables show the digit repeating ability or memory 
span of 3,488 children examined in New Castle County. One girl, 
age 14, repeated 13 digits. No other pupil was able to repeat 12 digits. 
Seven children, six girls and one boy, repeated 11 digits. These were 
the best records made during this test. The colored children did rela- 
tively better work in repeating digits than they did in the other 
sifting tests. These tables show that children between the ages of 

7 and 11 can repeat six digits. 

Table III. — Repetition of digits. 

White children of New Castle County, Del.; 1,612 boys examined; 1,429 girls examined. 

73 boys, age 15 and above. 79 girls, age IS and above. 

Digits. Digits. 

1 boy repeated 10 1 girl repeated 10 

8 boys repeated 9 7 girls repeated 9 

23 boys repeated 8 23 girls repeated 8 

22 boys repeated 7 31 girls repeated 7 

16 boys repeated 6 15 girls repeated 6 

2 boysre])eated 5 1 girl repeated 5 

1 boy repeated 4 1 girl repeated 4 

68 boys, age Ul. B6 girls, age Ui. 

1 boy repeated 10 5 girls repeated 10 

6 boys repeated 9 8 girls repeated 9 

20 boys repeated 8 1 1 girls repeated 8 

22 boys repeated 7 25 girls repeated 7 

8 boys repeated 6 6 girls repeated 6 

1 boy repeated 5 1 girl repeated 4 



MENTAL STATUS OF EUEAL SCHOOL CHILDREN. 



9 



Table III. — Repetition of digits — Continued. 
White children of New Castle County, Del.; 1,612 boys examined: 1,429 giris examined — Continued. 



7/f boys, age 11. 

I boy repeated 11 

4 boj's repeated .- . . 9 

28 boys repeated 8 

28 boys repeated 7 

II boys repeated 

1 boy repeated ' 5 

I boy repeated -1 

9i boys, (i(jc i;:?J. 

4 boys repeated 10 

10 boys repeated 9 

29 boys" repeated 8 

38 boys repeated 7 

II boys repeated 



98 boys, age 13. 

4 boys repeated 10 

10 boys repeated 9 

24 boys repeated 8 

38 boys repeated 7 

21 boys repeated 

1 boy repeated 5 

101 boys, age 12h. 

C boys repeated 9 

34 boys repeated 8 

44 boys repeated 7 

17 boys repeated 6 



89 boijs, age 12. 

1 boy repeate.d 10 

6 boys repeated 9 

19 boys repeated S 

46 boys repeated 7 

16 boys repeated 6 

I boy repeated 4 

83 boys, age 11\. 

4 boys repeated 10 

8 boys repeated 9 

II boys repeated 8 

36 boys repeated 7 

21 boys repeated 6 

3 boys repeated 5 



SI boys, age 11. 

6 boys repeated 9 

18 boys repeated 8 

31 boys repeated 7 

24 boys repeated 6 

2 boys repeated 5 

109 boys, age 10\. 

1 boy repeated 10 

5 boys repeated 9 

17 boys repeated 8 

47 boys repeated 7 

35 boys repeated 6 

2 boys repeated.. 5 

2 boys repeated 4 

89 boys, age 10. 

1 boy repeated 9 

9 boys repeated 8 

33 boys repeated 7 

42 boys repaeted 6 

2 boys repeated 5 

2 boys repeated 4 

131 boys, age 9\. 

2 boys repeated 9 

16 boys repeated 8 

50 boys repeated 7 

54 boys repeated 6 

8 boys repeated o 

1 boy repeated 4 

70793°— 16 -2 



59 girls, age 14- 

1 girl repeated 13 

3 girls repeated 10 

7 girls repeated 9 

15 girls repeated 8 

22 girls repeated 7 

9 girls repeated 

2 girls repeated 5 

93 girls, age ISh. 

2 girls repeated 11 

5 girls repeated ip 

7 girls repeated 9 

31 girls repeated 8 

32 girls repeated 7 

17 girls repeated 6 

1 girl repeated 5 

91 girls, age 13. 

1 girl repeated 11 

3 girls repeated 10 

9 girls repeated 9 

29 girls repeated 8 

35 girls repeated 7 

10 girls repeated 

4 girls repeated 5 

76 girls, age 12\. 

1 girl repeated lO 

4 girls repeated 9 

25 girls repeated 8 

32 girls repeated ; 7 

12 girls repeated 6 

2 girls repeated 5 

86 girls, age 12. 

1 girl repeated 11 

8 girls repeated 9 

24 girls repeated 8 

28 girls repeated 7 

21 girls repeated 6 

3 girls repeated 5 

1 girl repeated 4 

91 girls, age lUj. 

1 girl repeated 11 

2 girls repeated 10 

5 girls repeated 9 

16 girls repeated 8 

29 girls repeated 7 

33 girls repeated 6 

4 girls repeated 5 

1 girl repeated 4 

82 girU, age 11. 

3 girls repeated 10 

2 girls repeated 9 

18 girls repeated 8 

34 girls repeated 7 

24 girls repeated 6 

1 girl repeated 5 

77 girls, age 10^. 

2 girls repeated : 10 

3 girls repeated 9 

11 girls repeated 8 

30 girls repeated 7 

28 girls repeated 6 

3 girls repeated 5 

79 girls, age 10. 

2 girls repeated 10- 

3 girls repeated 9 

18 girls repeated 8 

29 girls repeated 7 

23 girls repeated 6 

4 girls repeated 5 

101 girls, age 9'^. 

3 girls repeated 9 

15 girls repeated 8 

36 girls repeated 7 

42 girls repeated 6 

5 gii'ls repeated 5 



10 



MENTAL STATUS OF BUBAL SCHOOL CHILDBEN". 



Table III. — Repetition of digits — Continued. 
White cliildren of New Castle County, Del.; 1,612 boys examined; 1,429 girls examined — Continued, 

78 girls, age 9. 

2 girls repeated 9 

12 girls repeated 8 

23 girls repeated 7 

37 girls repeated 6 

2 girls repeated 5 

2 girls repeated 4 



89 boys, age 9. 

1 boy repeated 10 

5 boys repeated 8 

30 boys repeated 7 

44 boys repeated 6 

9 boys repeated 5 



101 boy^!, age SI. 

1 boy repeated 10 

2 boys repeated.. 9 

10 boys repeated 8 

38 boys repeated 7 

35 boys repeated 6 

13 boys repeated 5 

2 boys repeated 4 



2 boys repeated. 
5 boys repeated. 
27 boys rei 
46 boys ) 
14 boys I 

3 boys repeated. 



97 boys, age S. 



69 bmjs, age 7}. 

1 boy repeated 9 

1 boy repeated 8 

16 boys repeated 7 

41 boys repeated 6 

7 boys repeated 5 

3 boys repeated 4 

69 boys, age 7. 

2 boys repeated 8 

11 boys repeated 7 

41 boys repeated 6 

12 boys repeated 5 

2 boys repeated 4 

1 boy repeated 3 

100 boys, age 6. 

I boy repeated 9 

II boys repeated 7 

43 boys repeated 6 

35 boys repeated 5 

17 boys repeated 4 

1 boy repeated 3 

1 boy repeated 2 



88 girls, age 8i. 

1 girl repeated ' 10 

2 girls repeated 9 

7 girls repeated 8 

29 girls repeated : . . 7 

37 girls repeated 6 

10 girls repeated 5 

2 girls repeated 4 

71 girls, age 8. 

6 girls repeated 8 

15 girls repeated 7 

42 girls repeated 6 

7 girls repeated 5 

1 girl repeated 4 



2 girls repeated . 

6 gii'ls repeated . 

17 girls 1 

45 girls ! 

11 girls ] 

1 girl repeated . 



8B girls, age 7|. 



66 girls, age 7. 

1 girl repeated 9 

2 girls repeated 8 

18 girls repeated 7 

36 girls repeated 6 

8 girls repeated 5 

1 girl repeated 4 

72 girls, age 6. 

I girl repeated 8 

10 girls repeated 7 

28 girls repeated 6 

21 girls repeated 5 

II girls repeated 4 

1 girl repeated 3 



Colored children of New Castle County, Del.; 202 boys; 245 girls. 

21 girls, age 15 and abov . 



21 boys, age 15 and above. 

Digits. 

1 boy repeated 10 

2 boys repeated 9 

6 boys repeated 8 

9 boys repeated 7 

3 boys repeated 6 

12 boys, age 14h. 

1 boy repeated 10 

2 boys repeated 9 

3 boys repeated 8 

6 boys repeated 7 



6 boys, age H. 



3 boys repeated . 
3 boys repeated . 



11 boys, age 13?^. 

3 boys repeated ; . . . 8 

5 boys repeated 7 

3 boys repeated 6 

5 boys, age 13. 

2 boys repeated 8 

1 boy repeated 7 

1 boy repeated 6 

1 boy repeated 5 



Digits. 

1 girl repeated 9 

8 girls repeated 8 

8 girls repeated 7 

4 girls repeated 6 



9 girls, age 141- 

3 girls repeated 9 

2 girls repeated 8 

3 girls repeated 7 

1 girl repeated 6 

7 girls, age I4. 

1 girl repeated 8 

3 girls repeated 7 

3 girls repeated 6 

12 girls, age 13i. 

5 girls repeated 8 

4 girls repeated 7 

3 girls repeated 6 

9 girls, age 13. 

1 girl repeated 9 

4 girls repeated 8 

3 girls repeated 7 

1 girl repeated 6 



MENTAL STATUS OF RURAL SCHOOL CHILDREN". 



11 



Table III. — Repetition 

Colored children of New Castle County, 



s, age 12^. 



5 boys repeated , 

2 boys repeated . 

3 boys repeated 
1 boy repeated . . 



14 boys, age 12. 

1 boy repeated 10 

5 boys repeated 8 

3 boys repeated 7 

4 boys repeated 6 

1 boy repeated 5 



15 boys, age Hi. 



4 boys ] 
9 boys rep 
1 boy repeated. 
1 boy repeated. 



10 boys, age 11. 

1 boy repeated... 10 

1 boy repeated- ^ 

6 boys repeated.. 7 

2 boys repeat ed " 



14 boys, age 10^. 



4 boys rei 
4 boys 
6 boys 



9 boys, age 10. 



Iboy repeated 8 

1 boy repeated... ' 

6 boys repeated. 6 

1 boy repeated. 5 

IB boys, age 9J. 

2 boys repeated.. 8 

8 boys repeated ' 

5 boys repeated. 6 

6 boys, age 9. 

1 boy repeated. . - 8 

2 boys repeated.. 7 

2 boys repeated '. . . 6 



10 boys, age 8J. 

2 boys repeated.. 8 

7 boys repeated. 6 

1 boy repeated... 5 

9 boys, age 8. 

3 boys repeated 7 

4 boys repeated.. 6 

2 boys repeated. 5 

IS boys, age 7^. 

1 boy repeated. 8 

4 boys repeated. 7 

3 boys repeated 6 

4 boys repeated 5 

IB boys, age 7. 

1 boy repeated. 8 

1 boy repeated... 7 

10 boys repeated 6 

3 boys repeated 6 



8 boys, age 6. 
i boys repeated 6 



of digits — Continued. 

, Del.; 202 boys: 245 girls— Continued. 

13 girls, age 121. 

2 girls repeated 8 

6 girls repeated 7 

5 girls repeated 6 

US girls, age 13. 

1 girl repeated 11 

2 girls repeated 9 

4 girls repeated 8 

7 girls repeated 7 

8 girls repeated 6 

20 girls, age m. 

2 girls repeated 9 

4 girls repeated 8 

7 girls repeated 7 

6 girls repeated 6 

1 girl repeated ' 5 

IB girls, age 11. 

4 girls repeated ' 8 

7 girls repeated 7 • 

2 girls repeated 6 

1 girl repeated 5 

1 girl repeated 4 

17 girls, age iOJ-. 

3 girls repeated 8 

10 girls repeated 7 

4 girls repeated 6 

12 girls, age 10. 

1 girl repeated 9 

2 girls repeated : 8 

3 girls repeated 7 

6 girls repeated 6 

12 girls, age PJ. 

2 girls repeated 8 

6 girls repeated 7 

4 girls repeated - 6 

17 girls, age 9. 

1 girl repeated 9 

5 girls repeated 7 

9 girls repeated 6 

2 girls repeated 5 

9 girls, age 8J. 

1 girl repeated 8 

4 girls repeated 7 

4 girls repeated . . . ., 6 

16 girls, age 8. 

7 girls repeated 7 

8 girls repeated 6 

1 girl repeated 5 

6 girls, age 7^. 

2 girls repeated 7 

3 girls repeated 6 

1 girl repeated 5 



16 girls, age 7. 

1 girlrepeated 9 

1 girl repeated 8 

3 girls repeated 7 

9 girls repeated 6 

1 girl repeated 5 

13 girls, age 6. 

4 girls repeated 7 

6 girls repeated 6 

2 girls repeated 5 

1 girl repeated 3 



12 MENTAL STATUS OF EUEAL SCHOOL CHILDREN. 

Problems. 

During the sifting process, the examiner propounded a problem in 
mental arithmetic to each child. Two trials were allowed. 

Children of the sixth, seventh, and eighth grades were given the 
same kind of problems (each child being given the 30-cent problem, 
the three-fourths problem, and the two-fifths problem). When the 
child failed in the three-fourths problem, however, the last one was 
not given. These problems were as follows: 

Thirty-cent problem: "If you have 30 cents and go to the post office and buy two 
2-cent stamps, two 1-cent stamps, and two postal cards, how much money will you 
have left? " Or, "If you have 30 cents and go to the post office and buy three 2-cent 
stamps, three 1-cent stamps, and three postal cards, how much money will you have 
left?" 

These problems may be thus expressed: 

30 cents-(2 2's+2 l's+2 p's)=? 

30 cents-(3 2's+-3 l's-j-3 p's)=? 

30 cents-(4 2's+4'rs+4 p's)=? 

30 cents-(5 2's-f 5 l's+5 p's)=? 

30 cents-(6 2's-f 6 l's+6 p's)=? 

Three-fourths problem: "If three-fourths of a farm cost |600, what will the whole 

farm cost?" Or, "If three-fourths of a farm cost 11,200, what will the whole farm 

cost? " and so on. . 

Two-fifths problem: "If two-fifths of a farm cost $800, what will one-half of the same 
farm cost? " "If two-fifths of a farm cost $1,200, what will one-half of the same farm 
cost? " "If two-fifths of a farm cost $2,400, what will one-half of the same farm cost? " 

In the fifth grade, the fraction problems were not used, the 30-cent 
problem alone being given. In the fourth grade the 20-cent problem 
was used: 

Twenty-cent problem: "If you have 20 cents, and go to the post office and buy two 
2-cent stamps and two 1-cent stamps, how much money will you have left? " 

These problems may be thus represented: 
20 cents-(2 l's+2 2's)=? 
20 cents-(3 1's-|-3 2's)=? 
20 cents-(4 1's-|-4 2's)=? 
20 cents-(5 1's+5 2's)=? 
20 cents-(6 l's-}-6 2's)=? 
In the third grade the 20-cent problem was given in a simpler form: 
Twenty-cent problem (third grade): "If you have 20 cents and spend 2 cents for 
bread and 2 cents for butter, how much naoney will you have left? " In each case 
the base number, 20, was retained, thus: ■ ^ 

20cents-(2+2)=? 
20cents-(3+3)=? 
20cents-(4+4)=? 
20cents-(6+6)=? 

In the second grade the 10-cent problem was used: 

10-(1+1)=? 
10-(2+4)=? 
10-(3+3)=? 
10-(5+2)=? 
10-(5+3)=? 
10-(l+5)=? 



MENTAL STATUS OF RURAL SCHOOL CHILDREN. 13 

The children in the first grade were given the finger problem : 

Finger problem: "I have five fingers (the examiner holding up his left hand and 
showing the five fingers), and if I take a knife and cut off these two fingers, how many 
fingers will be left on that hand? " Variations may be thus represented: 

5-2 = ? 

5-1=? 

5-3=?, etc. 

These problems throw light on the reasoning and learning ability 
of the children, as well as upon the quality of teaching they have 
received. 

The sifting process, or examination by means of the cube test, 
memory span, and problem, was given to all the children of New 
Castle County, with the exception of about 215 in the schools of the 
city of New Castle. 

SECONDARY EXAMINATION. 

Nature. 

If at the primary examination symptoms of mental abnormality 
occurred, the case was gone into more thoroughly. At the reexami- 
nation a Binet examination was made which occupied 20 minutes. 
Some other tests and questions were also propounded as the examiner 
deemed necessary. Some of these were: 

Reading. 

Spelling. 

Questions on general information suited to the subject's environment. 

Cube test. 

Days of the week backward. 

Months backward. 

Spelling backward. 

Counting backward. 

Interpretation of pictures upside down. 

[Addition series. 
Arithmetic|p^^^^g^g 

Counting money. 
Telling time. 

The subject was further tested by teaching him arithmetical 
processes step by step, grounding him first in concrete relationships 
and afterwards in abstractions. His ability to see into, catch on, 
retam^ and improve was carefully observed. This testing was 
planned to throw light upon the subject's attention, memory, learning 
power, reasoning ability, and emotional state. In many cases con- 
siderable information in regard to his intelligence and emotional state 
was obtained in this way. In addition to the above tests, questions 
were put to the subject as tht)ught feasible, in order to bring to light 
the whys and wherefores regarding his attitudes, interests, habits, 
emotional states, and health. His ordinary judgment or common 
sense was always inquired into. A physical examination was made 



14 



MENTAL STATUS OF RURAL SCHOOL CHILDREN. 



when necessary, special attention being directed to the vision, hearing, 
and neurological side. 

Brothers and sisters of the suspect as well as his teacher and princi- 
pal wej-e questioned. This was done in order to find data which 
would bear upon the past medical history, school history, and family 
history of the suspect. 

In addition, the character of the teaching which the child had 
received, together with the general tenor of the class or school, was 
considered. 

The age, sex, and especially the race of the child was constantly 

kept in mind. 

Results. 

As a result of this survey a group of 19 mentally defective children 

are presented. These cases are distinctive and positive. There are 

also 50 cases to which the term ''suspicions of mental deficiency" 

is apphed. Eight epileptics were found during the survey. Finally, 

there is a group of peculiar children which may be designated as the 

psychopathic group. No attempt was made to study tliis group 

minutely. 

Table IV. — Abnormal children I. 

19 MENTAL DEFECTIVES. 



Case. 


Race. 


Sex. 


Age. 


Grade. 


Binet age. 


1 


Cdored 

do 


Male 

Female 

...do 


18 years 


Ungraded. 

V and VI 

III 

I 

I 

VII 

IN 

II 
II 


7.2 


2 


17 years, 8 months 

16 years, 8 months 

15 years, 8 months 

14 years, 6 months 

14 years, 2 months 

14 years 


6.2 


3 


White •.. 


8.6 




do . . 


.do 




5 


do 


...do 


5.8 


6 .. 


do 


Male 

Female — 

Male 

.do 


7.4 


7 


do .. . 


7.2 


8 


do 


13 years, 7 months 

13 years 


9.8 




do 




10 


do 


Female.... 

Male 

Female — 

Male 

...do 


12 years, 11 months 

12 years , 5 months 

11 years, Gmonths 


7.2 


11 . . 


do 


9.4 




do 


8 


13 . 


do 


11 years, 1 month 

10 yearsj 5 months 

10 years 


Ungraded. 

I 
I 

Ungraded. 

I 


3 


14 


do 


3.2 


15 


do 


...do 


6.4 


16 


.do 


...do 


9 years 


4.6 


17 


Colored 

White 

Colored 


...do 


......do 


4 


18 . -. 


Female 

...do 


do 


5 


19 


8 years, 11 months 


5 







50 


MENTAL DEFECTIVES (SUSPICIOUS). 






20 ... 


Colored 

White 

do 


Male 

Female 

Male 

...do 


16 years, 10 months.... 
16 years, 11 months — 

16 years, 1 month 

15 years, 7 months 

15 years, 4 months 

15 years 


I 

VI 
VI 
V 
VI 
V 
V and VI 
VII 
V 

rv 

V 
V 

rv 
rv 
rv^ 
III 
III 
I 


7.2 


21 


10.6 


22 - 


11 


23 


do 


11.2 


24 ... 


do 


...do 


9.4 


25 


do 


.do 




26 


.do 


Female 

Male 

Female 


14 years, 7 months 

14 yeai'S 




27 


.do 


10.2 


28 


do 


.....do 


9.8 


29 


do 


...do 


13 years, 11 months.... 

13 years, 10 months 

13 years, 9 months 

13 years, 7 months 

do 


9.6 


30 


Colored 

White 


Male 

...do 


8.8 


31 


10.2 


32 


do 


Female — 
Male 


10.4 


33 


.do 


9.2 


34 


do 


Female 

...do 


13 years, (i months 

13 years, i month 

13 years 


9.4 


35 - .. 


do 


9.6 


36 


do 


Male 

Female 


10.6 


37 


do 


12 vears, 11 months — 


8.6 


38 


do 


Male 1 12 years, 10 months.... 


7.6 



MENTAL STATUS OF RURAL SCHOOL CHILDREN. 

Table IV. — Abnormal children I — Continued. 
50 MENTAL DEFECTIVES (SUSPICIOUS)— Continued. 



15 



Case. 


Race. 


Sex. 


Age. 


Grade. 


Binetage. 


39 


White 

Colored 


Male 

...do 


12 years , 6 months 

do.. 


IV 
I 

rv 

VI 


8.4 
7 

10 

11.4 
8.8 
8.6 
8.6 
7.8 
9.8 
8.8 
8 

6.6 
7.4 
8.8- 
6.4 
7.2 
8.2 
7.4 
7.8 
7.2 
6.8 


40 


41 


White 


.do 


12 years, 5 months 

12 years, 4 months 


42 


do 


...do 


43 


Colored 

.....do 


Female 

Male 

.. .do .. 


44 


12 years, 2 months 

12 years, IJ months 

12 years 


I 

III 
I 

II 
land rv 
II 
I 
I 
II 
I 
I 


45 


White... 


46 


Colored 

.do 


Female 

.do 


47 


do 


48 


do 


...do 


11 years 


49 .' 


White 


...do 


.. ..do 


50 


do...... 


Male 

...do 


10 years, 5 months 

.do 


51 


do 


52 


do 


Female 

Male 

Female 


do 


53 


do 


54 


do 


do 


55 


do 


...do 


9 years, 9 months 


56 


.do 


.do 


do 


I 
I 
I 
II 
II 
II 
I 
I 
I 
I 
F 
I 
F 
I 


57 


Colored 

White... 


Male 

.do 


9 years, 7 J months 

9 years, 6 months 


58 


59 


do 


..do 


60 


do 


...do 


do 


61 


do 


-do...... 


.do. 


6.3 

7.2 

5.8 

6.4 

4 

4.4 

4.4 

4.2 

4.6 


62 


Colored 

White 

. . .do 


Female 


. ..do 




Male . . 

do .. 


8 years, 7 months 

8 years, 3 months 

7 years, 10 months 

7 years, 6 months 

7 years, 2 months 

6 years, 5 months 


64 


65 L... 


do 


do 


66 


do 


Female 

...do 




Colored. . 


68 


White... 


-do.... 


69 


do 


Male 







8. EPILEPTICS. 



Colored. 
White... 

do... 

do... 

do... 

do... 

Colored. 
do... 



Male 

...do 

Female 

Male 

...do 

..do 

..do 

Female 



18 years, 7 months 

14 years, 6 months 

14 years, 2 months 

13 years, Hi months... 

12 years, 6 months 

11 years 

10 years 

7 years, 5 months 



VI 


11.0 


V 


10.6 


III 


9.6 


VIII 


11.2 


VI 


11 


II 


8.8 


I, II, III 


7.4 


I 


7.2 



9. SUBNORMAL CHILDREN WHO GIVE A HISTORY OF ATTACKS OF UNCONSCIOUSNESS. 



78 


White 

do........ 


Male 

...do 


16 years, 6 months 

15 years, 3 months 

13 years, 11 months 

13 years, 6 months 

12 years, 6 months 

11 years, 3i months 

10 years, 6 months 

9 years, 8 months 


V 
VI 
VI 
V 

rv 

IV 

III 


9.4 
11.2 
11 

10.2 
9.6 
9.2 
9.2 
7.4 
5.6 


79 


80 


.do 


.do.... 


81 

82 


Colored..;.. 
White 


...do 

.do.... 


83 


do 


Female 

.do.... 


84 


. ..do 


85 


do 


. .do 


86 


do 


Male 




I 









PECULIAR CHILDREN. 



87 


White 

do 


Male 

..do 


14 years, 10 months 


VII 

rv 


11.8 
10.4 


8S 


89 


do 


...do 


13 years 


90 


do 


Female 

do.... 






91 


.do.... 


12 years, 6 months 

do 


III 
rv 

VI 

V 
IV 
HI 
III 

I 

1 


10.2 
11 
9.8 


92 


....do 


..do 


93 


do ... 


do ... 


12 years, 4 months 


94 


do 


...do 


95 


do.... 


do 


11 years, 10 months 

11 years, 2 months 


8.4 
9.2 
8 

8 

8 


96 "... 


. .do 


-do.... 


97 


do. .. 


Male 

..do.... 


98 


...do 


7 years, 11 months 

7 years 


99 


.do 


.do . 









16 MENTAL STATUS OF ETJEAL SCHOOL CHILDEEN. 

CONCLUSIONS AND RECOMMENDATIONS. 

1. Mental deficiency can not be diagnosed by means of the Binet 
scale alone. This is shown in Tables I and IV, where it may be ob- 
served that some children who measure 9 and 10 years by the Binet 
scale are considered normal, while other children of the same chrono- 
logical age, who measure 10 and 11 years mentally by the Binet 
scale, are considered mentally defective.^ 

2. The Binet tests are an excellent means for finding out the various 
mental abilities of an individual. During the application of these 
tests much light is thrown upon the subject's general fund of infor- 
mation, and an opportunity is afforded to observe the quickness and 
the character of mental operations, emotional states, and abnormal 
mental symptoms. 

3. The employment of selected tests is a rapid and effective method 
of differentiating subnormal children in schools for purpose of diag- 
nosis. 

4. Normal children 8 years of age and over 3hould perform four 
movements out of six movements with the four-cube test. , 

5. Normal white children 12 years of age and over should perform 
two out of four movements with the five-cube test. 

6. Normal children between the ages of 7 and 11 years should be 
able to repeat six digits. 

7. Five-tenths of 1 per cent of 3,793 rural school children examined 
in New Castle County are definitely feeble-minded and in need of 
institutional treatment. 

8. An additional 1.3 per cent of the total number were so retarded 
mentally as to be considered probable mental defectives and in need 
of institutional care. 

9. A number of mentally defective children were encountered who 
exhibited s.ymptoms similar to those which are observed in the adult 
insane. 

10. It is believed, as a result of this survey, that epilepsy is a more 
prevalent disease than it has heretofore been thought to be. 

11. The defective school children encountered in the schools of New 
Castle County hamper school work just as in other places. In 
some instances they are a real source of danger to other pupils, and 
many of them are in school because there is no place to put them. 

12. It can not be too strongly recommended that the State of 
Delaware provide a home for the feeble-minded and other defective 
individuals who are without proper guardianship where they may be 
segregated and taught under proper supervision to be self-supporting. 

13. It is furthermore strongly recommended that proper measures 
be taken for the formation of special classes to supply needful train- 
ing to retarded children in the schools of the State. 

' The writer personally believes that the term Binet-score should be substituted for the term Binet-age 
and that "12 points," instead ol Binet-age of 12, should be considered the maximum score. 



THE MENTAL STATUS OF RURAL SCHOOL CHILDREN OF PORTER 

COUNTY, IND.i 



In the course of this survey, a study was made of the mental con- 
dition of each child. The purpose was not only to determine the 
number of mental defectives which require special or individual 
treatment, but to study the influence of school surroundings on men- 
tal status. Coincidently, studies were made to determine the value 
of the Binet-Simon tests for grading intelligence. 

A total of 2,185 children was thus examined, special reliance 
being placed in the Binet tests with some modifications. In the case 
of exceptionally retarded children revealed by these tests, however, 
special methods were employed to determine the degree of mental 
impairment. 

HISTORY OF THE TESTS. 

As is known, Binet and Simon, on data collected during the 
examination of 200 normal French school children, devised a series 
of tests for different age periods. As originally devised, the number 
of tests for each age group varied from four to seven. In 1911 the 
tests were revised, and the number for each age group was fixed at 
five, except that of the four-year group, which contains four tests. 
This revision was based on the examination of 203 French school 
children. Of this number, the observers gave tabular results for 
192, as follows: 

Table XI. — Mental and chronological ages of 192 French school children examined by 

Binet and Sivion? 



Chronological age. 


3 


4 


5 


6 


7 


8 


9 


10 


11 


12 


Total. 




3 
3 


9 
2 
1 
4 
1 


13 
6 


5 
8 


7 
7 


16 
5 
1 
1 


11 

9 


14 
2 


13 


2 


93 




42 








2 




4 


4 


6 
1 


3 
1 


2 


9 
3 


5 
2 


5 

4 


43 




12 












Total. . 


10 


17 


23 


20 


18 


23 


22 


28 


20 


11 


192 







1 Reprinted from Public Health Bulletin No. 77, "Rural-School Children, Including Physical and 
Mental Status of School Children in Porter County, Ind.," by Sui-gs. Taliaferro Clark and George L. 
Collins, U. S. Public Health Service, and Asst. Surg. W. L. Treadway, U. S. Public Health Service. 1916. 

2 In this classification, ' ' regular " signifies that the child's mental age is the same as the chronological age. 
Advanced and retarded are self-explanatory. , 

17 



18 



MEI^TAL STATUS OF EUEAL SCHOOL CHILDREN. 



It will be observed in the above table that nearly half the children, 
were regarded as regular, while those retarded and those advanced 
one year were about equal in number. Only 14 of the 192 showed 
a departure from the regular of more than one year. 

These tests were the first of this character devised for the purpose 
of determining the degree of intelligence of children in terms of 
mental ages. By reason of their simphcity they became widely 
popular. 

The tests have been objected to by some on the ground that they 
are mainly tests of the intelHgence. They certainly do not aim at 
a systematic determination of the development of any particular 
mental function. They have been found, however, in an empirical 
way, to give results which show the general mental development of 
the child. 

The Binet-Simon tests do not extend beyond the chronological 
age of 12, because, following this age period, the mental content 
becomes more intricate, and a small number of tests at any subse- 
quent age would be far from accurate. 

Because of the objection that Binet and Simon examined too 
small a number of children to establish norms, Goddard determined 
the norms for these tests in the case of 2,000 American school children. 
His results in the case of 1,532 children are given in the following 
table : 



Table XII. — Mental and chronological ages of 1,532 American school children examined 

by Goddard. 





Chronological age. 


Mental age. 




2 


3 


4 


5 


6 


7 


8 


9 


10 


11 


12 


13 


Total. 


4 


' 




1 


3 

8 
3 
2 
2 


2 
40 

29 
8 
2 


3 

40 
48 
15 

1 
















8 


5. . . .... 


2 

1 


4 
.... 


16 
69 
14 

87 

27 

15 

4 

4 

1 


4 

9 

50 

86 

54 

24 

13 

10 

5 

1 












114 


6 


■"■4" 
16 
56 
19 
25 
13 
6 
1 
3 


1 
3 

12 
58 
134 
50 
42 
30 
6 








160 










197 


8. . . ; 




3 

4 

27 

60 

36 

19 

5 

1 






209 


9 . . 






2 
8 
12 
39 
21 
4 
2 


"2 
1 
7 
3 


201 


10. . .. 












219 


11 












165 


12 












151 


13 












85 


14 












17 


15 - -- --- 














6 




Total 




















3 


6 


17 


81 


107 


337 


256 


143 


326 


155 


88 


13 


1 532 









It wiU be observed in the above table that up to the age of 9 
nearly all of the children of each age group graded either regular, 
one year advanced or one year retarded. In the succeeding age 
groups nearly aU of them graded either regular, one year advanced 
or two years retarded, with the exception of the 10-year-age group, 
in which nearly as many children graded three years retarded as 
were retarded only one year. 



MENTAL STATUS OF RURAL SCHOOL CHILDREN. 



19 



METHOD OF EXAMINATION AND GRADING. 

Goddard's revision of tlie Binet-Simon scale, Avith the addition 
of his 15-year old and adult test groups, was used in this survey. In 
one-room schools the children were examined in the classroom, in 
schools of more than one room, in a room where physical examina- 
tions were being made. In other words, the examination was not 
made in a quiet place, but in one that represented in part the child's 
daily schoolroom environment. 

The following method of grading was employed: The child was 
given a basal mental age corresponding to the age group in which 
he successfully passed all the tests, and to this one year was added 
for each five tests passed successfully in the higher age groups. For 
example, if in addition to aU the 8-year tests he also passed 3 in 
the 9-year group and 2 in the 10-year group, he was graded as having 
a mental age of 9 years. 

In the case of the 12-year-old group, however, in view of the in- 
abiUty of a large number of 12-year-old children to repeat a sen- 
tence of 24 syllables, a child successfully passing all five of these 
tests and one of the 15-year group was classed as 13 mentally. 

Children were classed as 15 years old mentally when they passed 
all of the 15-year-old tests, but less than half of the adult tests, and 
as adults when they passed 75 per cent of the adult tests. 

Statistical results of the application of the Binet-Simon tests to 
2,185 rural school children of Porter County in the first to eighth 
grades, inclusive, are given in the following table :^ 

RESULTS OF MENTAL EXAMINATION. 

Table XIlI. — Chronological and mental ages of 2,185 children attending the rural 
schools of Porter County, Ind., in terms of per cent. 





Mental age in terms of per cent of the total in each age group. 


Chronological age. 


4 


5 


6 


7 


8 


9 


10 


11 


12 


13 


15 


A. 


Total 
exam- 
ined. 


5 




33 + 

18.7 

5.6 

1.7 

.92 

.36 


42.25 
37 + 
23.7 

6.-0 

3.7 
.72 


23+ 
33.7 
37.9 

12 
6.5 
2.5 
1.8 


11.5+ 

16.8 

25.8 

44.5 

29.1 

16.3 

6.6 

2.6 

2.4 
.55 

2.9 
















26 
107 
232 
234 
216 
278 
212 
243 
249 
181 
136 
57 
11 
2 


6 


2.8 
.43 
.42 
.92 


'5.'2'" 

18.8 
31.4 

23.7 

9.9 
10.3 

5.6 

4.9 
11.7 

7+ 

9+ 


0.93 

8.6 

6.4 
22.7 
40.7 
35.3 
21.0 
19.5 

7.7 

8.8 
10.5+ 

9.0+ 


t 








7 


n 4S 








8 


2.1 
4 1 










9 


4R 








10 


12 9 '> ^ 


0.36 
1.8 
5.7 
13.6 

21.5 
19+ 
14+ 
9+ 






11 --.. 




35.3 

37.8 
35.8 
28.7 
14.7 


8.9 
33.3 

20.1 
24.3 
13.4 







12 








0.82 
2.8 
11.6 

38 + 

28+ 

18.2 


'i'.i" 

1.7+ 
9+ 


13 








.4 
.55 


14 








15 








16 










17 










9+ 


18.2 118.2 
50 50 


18 










19 
























20 
















i 


100 






1 


Total 


7 


46 


119 


204 


324 


280 


' 387 


390 210 


128 


86 


4 


2,185 



1 In. this tabulation a child was recorded as having the chi-onological age of his nearest birthday and 
likewise as havmg the nearest mental age (when grading mentally in fractions of a year). 



20 MENTAL STATUS OF EUEAL SCHOOL CHILDREN". 

Limits of Normality. 

A glance at the foregoing tables of Binet-Simon and Goddard will 
show that large numbers of normal children, chronologically 6, 7, 8, 
and 9 years of age, graded either regular, one year advanced, or one 
year retarded. In the case of children 10, 11, and 12 years old, chro- 
nologically, large numbers graded either regular, one year advanced, 
or one or two years retarded. 

In the case of 13-year-old children, however, those retarded as 
much as three years are regarded as normal, because nearly all of 
the children of the series come within these limits. Thirteen-year-old 
children who grade 15, however, must be regarded as "exceptional 
children." The 14, 15, and 16 year old children graded largely 
within the limits of 11 and 15 years mentally and those of 17 to 20 
years of age from 12 to adult. 

Classification of Retarded and Exceptionally Retarded Children. 

The mental progress of a child is rapid for the first few years of 
its life but becomes slower as maturity is approached. There is, 
as yet, no means of measuring this rate of progress. The difference 
in the mental development of a normal 2-year-old child and one 3 
years old is readily recognized. This difference becomes difficult to 
note between the ages of 6 and 7, and between 11 and 12 years of 
age the recognition of mental difference by ordinary observation is 
quite impossible. 

Mental development during any one-year period does not represent 
accurately a unit of mental growth, because the older the child the 
less rapid is the rate of mental development and the less noticeable 
is the retardation in any one year age period. 

Moreover, retardation in very young children presents two possi- 
bilities. In the first place, owing to the greater number of years 
intervening before maturity, these children -eventually may attain 
normal mental development. On the other hand, retardation may 
accumulate and become increasingly evident with advancing age. 
In consequence, the ultimate mental development of young children 
thus classified can not be foretold. 

The problem is not so complex, however, in the case of adults or 
individuals who have reached a chronological age at which the rate 
of mental development is slower. Retardation below a certain point 
can not be overcome in the short time intervening before maturity 
at the slower rate of development, and the mental status in these 
cases may be determined with certainty. 

The classification used in this report is based on the above con- 
siderations and children are recorded as retarded and exceptionally 
retarded. With the former the possibility remams of ultimate nor- 



MENTAL STATUS OF RURAL SCHOOL CHILDREN. 21 

mal mental development, while with the latter the mental develop- 
ment will never be greater than that of a child when adult age is 
reached. 

A graphic representation of the classification employed in these 
studies is shown in chart 10. Keference to it will show that children 
of 6 years who were 4 mentally, of 7 who were 5, of 8 who were 5 or 
6, of 9 who were 6 or 7, of 10 who were 6 or 7, of 11 who were 7 or 8, 
of 12 or 13 who were 8 or 9, of 14 or 15 who were 9 or 10, of 16 who 
were 10, of 17 to 20 who were 11, are classified as exceptionally 
retarded. 

The method of classification used is considered conservative. 
Although this classification may not include all the mental defectives 
in a school population, because of the inability to determine posi- 
tively subnormality in the very young children of the lower grades, 
and who must, therefore, be regarded as retarded only, still the 
method is more reliable than the arbitrary grading of children as de- 
fectives who are retarded as much as three years. The adoption of 
the latter procedure would have recorded a percentage of feeble- 
mindedness for this county far in excess of actual conditions. 

RETARDED CHILDREN. 

Retarded children are to be found in every- large school system. 
It has been stated that 50 in every 1,000 public-school children have 
difficulty in keeping up with their work and are in need of individual 
assistance. 

Of the 1,087 girls and 1,098 boys examined m the rural schools of 
Porter County, 93 of the former and 100 of the latter were retarded, 
and, excluding the exceptionally retarded children, constituted 8.7 per 
cent of the number examined. Including the exceptionally retarded 
children, the whole number of children requiring special attention 
was 214, or 9.3 per cent. 

Defects Associated With Retardation. 

The delicate physical and mental adjustments of children are 
much more easily upset than is the case with adults. Minor physical 
defects, which ordinarily make no impression upon a grown person, 
may prevent the normal physical and mental growth of the child. 
Defects of vision and hearing, defective teeth, adenoids, enlarged 
tonsils, nutritional disturbances, and certain general diseases react 
injuriously on both the physical and mental development of the 
child. It becomes important, therefore, to consider the hampering 
cffeets of physical defects and diseases in connection with mental 
retardation, and to take steps for their correction when possible. 



22 



MENTAL STATUS OF EUKAL SCHOOL CHILDREN". 




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** THE /iDVA/\/C£D OR EXCEPF/ON/iL CHILd! 



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Normal mental age limits for one-year chronological age periods, and limits for advanced, retarded, and 
exceptionally retarded children, measured by Binet-Simon scale. 



MENTAL STATUS OF RUEAL SCHOOL CHILDREN. 23 

Thirty-five per cent of the 93 retarded girls found in the rural 
schools of Porter County were undersized, 41.1 per cent were of 
normal size, and 23.5 per cent were above the county average in 
height and weight. Furthermore, 58.8 per cent had defective eye- 
sight, 26.4 per cent had defective hearing, 1.7 per cent had adenoids 
associated with enlarged tonsils, 2.9 per cent had enlarged tonsils 
without adenoids, and 17.6 per cent had defective teeth. 

Thirty-eight per cent of the 100 retarded boys were midersized, 
30 per cent were of normal stature, and 32 per cent were above the 
county average of height and weight. In addition, 47 per cent had 
defective eyesight, 19 per cent had confused color discrimination, 
34 per cent had defective hearing, 6 per cent had adenoids and 
enlarged tonsils, 17 per cent had defective teeth, and one child had 
a cleft palate. 

Two or more physical defects were frequently associated in the 

same child. 

Other Causes of Mental Retardation. 

Improper teaching methods are responsible for much of the re- 
tardation found in schools. The teachers of the public schools of 
the country have imposed upon them a great responsibility, no 
small part of which is the molding of character. Education is some- 
thing more than imparting instruction. Young people who adopt 
teaching as a temporary avocation do not meet with the same success 
in training children as do those who make this profession a life work. 
The training of teachers, therefore, and their selection, warrant the 
most careful consideration, because, in addition to technical training, 
the successful teacher must be adaptable and have the ability to 
broaden the outlook upon life of certain types of introspective 
children. 

Poorly equipped school buildings, defective illumination, faulty 
ventilation and heating, uncomfortable seats, and unattractive sur- 
roundings operate to cause retardation. The discomfort experienced 
in buildings of this type produces a hampering effect on the mental 
concentration necessary for educational purposes. The provision 
of school buddings erected in accordance with modern sanitary prin- 
ciples will do much to reduce the amount of retardation appearing 
in school children. 

In a number of instances children have been advanced in grade 
without proper preparation. A child who has failed to acquire the 
fundamentals in a lower grade can not properly do the work in the 
higher classes, and, when unduly promoted, suffers injurious retarda- 
tion. Children of this type frequently quit school with a poor educa- 
tional equipment. 

In Porter County the average loss of grade by retarded children, 
as recorded byteacherSj was 1.28 years for girls and 1.5 years for 
boys. 



24 MENTAL STATUS OF EUEAL SCHOOL CHILDEElSr. 

Mental retardation is most frequently met with in crowded one- 
room schools where several grades are taught by one teacher. A 
number of schools of this type are m operation in Porter County. 
Where the number of pupils in attendance is large, the time of the 
teacher is too occupied by routine duties to permit of individual 
instruction of children who find difficulty in mastering the funda- 
mentals of education. 

Care of Retarded Children. 

Children who are unable to advance in school work by methods 
which are effective in regular classes require special educational 
facilities, which are of practical attainment through the organiza- 
tion of special classes. The organization of such classes rarely can 
be accomplished in districts where there are principally one-room 
schools by reason of the increased cost. The consolidation of rural 
schools, however, offers facilities for special classes and in.dividual 
instruction to larger groups of children who would otherwise remain 
misfits in the smaller schools. 

Wherever such classes are organized the retarded children should 
not be segregated in the most undesirable room in the building. 
Moreover, the teachers should have special qualifications for this 
kind of instruction and hot be selected because of years of experi- 
ence in other branches of pedagogy. They should have training in 
the management of children, a knowledge of the methods employed in 
correcting speech defects, and a fair understanding of some of the 
problems of psychology as related to the child and of the principles 
of physiology. 

The value of special classes for retarded children is shown by the 
fact that 5.0 per cent of the children who are placed in such classes 
rejoin their proper grade when faulty methods are corrected and 
physical conditions improved. 

EXCEPTIONALLY RETARDED CHILDREN. 

Of the 1,087 girls and 1,098 boys examined in the rural schools 
of Porter County 7, or 0.6 per cent, of the former and 14, or 1.2 per 
cent, of the latter were so exceptionally retarded that their mental 
development at no time will be greater than that of a child. 

Defects Associated With Exceptional Retardation. 

Twenty-eight per cent of the exceptionally retarded girls were 
undersized and 57 per eent were above the average physical develop- 
ment of the county, as compared with only 23.5 per cent of the girls 
who were simply retarded. Furthermore, 42.8 per cent had defec- 
tive eyesight, 14.2 per cent had defective hearmg, and 2.9 per cent 
had enlarged tonsils. 



MENTAL STATUS OP RURAL SCHOOL CHILDREIT. 25 

Of the exceptionally retarded boys, 28.5 per cent were under- 
sized, 28.5. per cent were of normal physical development, and 42.8 
per cent were above the average for the county in height and weight. 
In addition, 34.2 per cent had defective eyesight, 57.1 per cent had 
defective hearing, and 7.1 per cent had enlarged tonsils. 

Among the exceptionally retarded children the average loss of 
grade, as recorded by teachers, was 2.1 years for girls and 2.5 years 
for boys. 

The nimiber of exceptionally retarded children consitnted 0.9 
per. cent of the total nmnber examined. This does not include all 
of the defectives among children of school age in the county. It 
must be assumed that some children, by reason of grave mental 
defects, were unable to attend school. 

Characteristics of Exceptional Retardation. 

Mental deficiency, or feeble-mindedness, as it is more often termed, 
has been defined as a lack of normal mental development. Individ- 
uals of this class can be educated to a degree, but with them mental 
progress is so decidedly slow that thek mental capacity is no greater 
^han that of a child, even when adult life is reached. Persons 
whose intelligence is developed to so shght a degree are misfits 
in a society arranged for people whose mental development contin- 
ues until the retrogressive changes of old age begin. They become 
dependents because of their inability to compete with persons of 
higher mteUigence, immoral because unable to adjust their sexual 
problems to moral laws, and delmquent because they do not mider- 
stahd the significance of laws devised for the protection of society. 

Causes of Exceptional Retardation. 

A defective heredity, insanity, alcoholism; and syphilis in one or 
both parents are considered responsible for most of the cases of 
mental defectives. A large part of the evidence that heredity is an 
important causative factor of mental deficiency is based on indirect 
testimony. The great value of investigations of this character is 
the determination of existing cases of mental deficiency as a start- 
ing point for future studies of the influences of heredity on succeed- 
ing generations. 

Of the other causes of mentax deficiency may be mentioned con- 
genital defects, injuries, and nutritional disturbances. Improvement 
by better sanitation of the health of communities wiU be followed 
also by a reduction in the number of mental defectives. 

Number of Exceptionally Retarded Children. 

According to the United States census report, 1910, 20,000 mental 
defectives were in special institutions in this country. Mental exami- 
nations of a large number of persons in prisons, penitentiaries, jails. 



26 MEisrrAL status of rukal school children. 

and workhouses during the last few years show at least a third of the 
number examined to be mentally defective. At this rate not less 
than 40,000 of the 136,472 persons in such institutions, including those 
for juvenile delinquents, in 1910 were mental defectives. 

It has been estimated that 20 in each 1,000 American school 
children are mental defectives/ and that 2 in 1,000 of the general 
population are mental defectives. On the basis of the lowest figures 
it is estimated there are at least 200,000 feeble-minded persons in the 
United States. As a conservative estimate, about 130,000 feeble- 
minded persons are without institutional care of any description. 
Only 26 States have provided institutions for the feeble-minded 

Care of Mental Defectives in Indiana. 

In 1879, a department for feeble-minded children was established 
as an adjunct to the Soldiers' and Sailors' Orphans' Home at 
Knights town, Ind. The legislature, by an act approved March 7, 
1887, gave the institution an independent existence and changed the 
name to Indiana School for Feeble-Minded Youth. A new institu- 
tion was built at Fort Wayne. It was not occupied, however, until 
July 8, 1890. 

The privileges of the school are extended to feeble-minded, idiotic, 
epileptic, and paralytic children under 16 years of age. Since 1901 
the school has maintained a custodial department for feeble-minded 
women between the ages of 16 and 45 years. These women are com- 
mitted by the courts (Laws, 1887, p. 47; 1901, p. 156). A colony 
farm containing 509^ acres has been in operation since 1893. 

The superintendents of the various almshouses in Indiana, in 1914, 
reported 489 feeble-minded men and 380 feeble-minded women in 
the various almshouses of the State. Of the 380 feeble-minded wo- 
men, 118 were within the child-bearing age period. Of the 3,228 
almshouse inmates, 1,389, or 43 per cent, were insane, feeble-minded, 
or epileptic.^ 

Education of Feeble-Minded. 

The aim of the education of feeble-minded children should be to 
train them to be self-supporting. Intellectual training, in its nar- 
rower sense, is of secondary importance. 

Most American institutions for the feeble-minded are broadly 
divided into two departments — educational and custodial. The edu- 
cation of the feeble-minded, compared to that for normal children, 
differs in degree only and begins at a lower plane. Satisfactory 
gradations or classifucations are made so that children with irregular 
and unusual deficiencies receive individual training in special classes. 

1 The number of mental defectives found in this survey was not greater than 9 in 1,000. 

2 Twenty-fifth Annual Report of the Board of Charities of Indiana, September, 1914. 



MENTAL STATUS OF RURAL SCHOOL CHILDREN. 27 

The most prominent feature of the education of the feeble-minded, 
however, is their training in industrial occupations and manual labor, 
as now successfully and profitably carried on by the pupils in these 
schools. Through correct training of this character a certain num- 
ber of these individuals lead useful lives after leaving the institu- 
tions. About one-half the higher grades of mental defectives who 
have been under training from childhood are self-supporting, under 
intelhgent supervision, whether in an institution or at home. It is 
especially important to begin training of this character early in the 
child's hfe. 

Mental Deficiency and its Relation to the Community. 

Recent investigations of the defective and delinquent classes have 
demonstrated that a large percentage of criminals, paupers, tramps, 
and prostitutes are really congenital imbeciles who have been al- 
lowed to grow up without training or disciphne. Society suffers the 
penalty of such neglect through an increase in pauperism, vice, and 
crime, and the greatly increased cost of the care of adult feeble- 
minded persons. 

Feeble-minded girls, exposed to evil influences, are unable to pro- 
tect themselves from the perils peculiar to women. There is hardly 
a poorhouse in this country which has not one or more feeble-minded 
women who are mothers of several illegitimate cliildren. It is often 
the case, in rural communities, that a girl of this type, when illegiti- 
mately pregnant, has no place to go except to the almshouse. After 
the community has borne the expense of three or four confinements, 
she is finally committed to. an institution for the feeble-minded. 
From every consideration of morality, humanity, and public pohcy, 
feeble-minded women should be under permanent and watchful 
guardianship, especially during the child-bearing age. 

OTHER MENTAL CONDITIONS WfflCH REQUIRE SUPERVISION. 

Epileptics. 

During the course of this survey tliree epileptic children were 
observed. One of these was feeble-minded. 

The State of Indiana has provided an institution for cases of this 
type, which is located near New Castle. All epileptics having a 
legal settlement in the State are admissible. 

Recent studies of juvenile offenders show that a fair per cent of 
them are afflicted with epilepsy. It is estimated that every juvenile 
epileptic offender, because of his constitutional tendency to corrupt 
others, in the end will cost the State the sum of $6,000. It is im- 
portant, therefore, for communities to realize that, because mental 
conditions play no small part in the production of crime, early rec- 
ognition of these cases and suitable provisions for their supervision 
and training will obviate future expense. 



28 MEISTTAL STATUS OF RURAL SCHOOL CHILDEElSr. 

Juvenile Delinquent., 

In every community there are a number of children who are morally 
irresponsible. They show no marked deficiency of the intellectual 
faculties, but early in childhood manifest a perversion of the moral 
sense, which is shown by motiveless, persistent lying and thieving, 
an impulse to arson and cruelty to animals and to younger or help- 
less companions. These constitutionally inferior persons comprise a 
large percentage of habitual criminals. The presence of one or more 
children of this type in school exercises a pernicious influence that 
is usually associated with an increase in the number of children who 
fail to make grade. It is undesirable to permit children of this type 
to attend school. It is still more undesirable to turn them loose on 
the community without restraint, because they are potential crimi- 
nals in a poor environment. It is incumbent on the State, therefore, 
to care for such children and give them suitable training. 

During the course of this survey two marked cases of this type 
of mentality were found. 

State 'provision for juvenile offenders. — The State of Indiana has 
established two schools for the correction and reformation of juvenile 
offenders. That for boys is established on a farm near Plainfield and 
receives boys committed for crime from 8 to 16 years of age. In the 
case of incorrigibility, however, the commitment age is from 10 to 
17. The term of commitment continues until the boy is 21 years of 
age. One-half of the cost of caring for each boy is paid by the 
county from which he is committed. 

The daily average attendance is near 600 boys. 

The Indiana girls' school is situated on a farm near Clermont. 
The age of commitment for girls is from 10 to 18 years of age. The 
term of commitment is until 21 years of age. 

The daily average attendance is a little over 300. 

In Indiana the judge of the circuit court is the guardian of all 
children who need State protection. In addition, the State has 
formed a board of children's guardians, which is composed of six 
members, three of whom are required to be women. Each member 
must be a parent. 

The practice of committing juvenile offenders without an attempt 
to determine their mental status is not a good one. The possibihty 
of a miscarriage of justice by this procedure is very great. It is 
desirable that courts which deal with children should have attached 
to them a competent psychologist to determine the children's mental 
status. Furthermore, the combination of these duties with that of 
the mental inspection of school children would be practicable. A 
psychologist attached to the courts could bring about the proper 
segregation of the feeble-minded in places other than the county 
almshouse, which is so unsuitable for the purpose. 



MENTAL BTATTJS OF RUBAL SCHOOL CHILDRElSr. 29 

SUMMARY. 

Children were classified as normal, retarded, and exceptionally 
retarded, the latter comprising all children with mental deficiency. 

The Binet-Simon tests were used in this survey to show the gen- 
eral mental development of the children examined. In the case of 
the exceptionally retarded children, however, special methods were 
employed to determine the mental status of each child so recorded. 

Of the 1,087 girls and 1,098 boys examined in the rural schools, 93 
of the former and 100 of the latter were below the average mentally, 
or 8.7 per cent of the whole number. The total number needing 
specialized instruction, was 214, or 9.3 per cent. 

Seven girls, or 0.6 per cent, were retarded in such degree that their 
mental development at adult life would not be greater than that of 
children. Of these, 28 per cent were below the mean physical devel- 
opment for the county. 

Of the boys, 1.2 per cent were exceptionally retarded. Of these, 
28.5 per cent .were below the mean physical development of the 
county as a whole. Of the total school population, 0.9 per cent were 
mental defectives. The percentage of exceptionally retarded chil- 
dren recorded in the county is considerably less than that found by 
other observers in other localities. 

Of the physical defects associated with retardation, those of the. 
special senses, with the exception of defective hearing, were found 
in greater proportionate numbers among children who were simply 
retarded. The exceptionally retarded children were above the aver- 
age stature of the county in greater proportionate numbers than 
retarded children. 

The undue number of one-room rural schools in the county which 
were of f-aulty construction, with poor equipment, and with imper- 
fect teaching facilities, were largely responsible for the retardation 
found in the county. 

The average loss of grade by 193 children, as recorded by teachers, 
was 1.28 years for girls and 1.5 yea.rs for boys, a total of 269 school 
years. 

No special classes for the instruction of retarded children were 
found in any of the rural schools of the county. 

In addition to the 214 children who were retarded and excep- 
tionally retarded, 3 epileptics and two constitutionally inferior cliil- 
dren were found among the school children of the county. 

CONCLUSION. 

The undue number of mentally defective and retarded school 
children revealed by these exammations emphasizes the necessity 
of the mental classification of the children of the county for the pur- 
pose of revealing those who are in need of institutional or mdi- 
vidualized treatment. "^\- 



30 MENTAL STATUS OF RITRAL SCHOOL CHILDREN. 

RECOMMENDATIONS.! 

(10) The duties of medical inspector of schools should be com- 
bined with those of local health officer. 

(11) A full-time officer should be required to be appointed for 
the discharge of these combined duties, thereby preventing the 
spread of disease in the school and improving health conditions in 
the county. 

(12) It would be desirable for the above-mentioned ofiicer to be 
affiliated also with the juvenile courts or other courts having jurisdic- 
tion over juvenile delinquents to make mental examinations of such 
offenders for the purpose of mental classification in the interest of 
justice. 

(13) Steps should be taken to secure institutional treatment for 
the mental defectives in the county. 

(14) Measures should be taken to secure special classes and indi- 
viduahzed instruction for children who are simply retarded and fail 
to make grade. 

1 Recommendations 1 to 9 refer to sanitary condition of schools and physical status of school children. 



LIBRARY OF CONGRESS jtl 



019 842 528 fl 



